Resident Advocate: Nursing Home Fines Must Increase to Improve Care, Prevent Harm

Between a new Medicare payment model and increased scrutiny on nursing home safety from the federal government, 2019 may go down as a watershed year for skilled nursing regulations. But at least one patient advocate says the government — particularly under the Trump administration — hasn’t gone far enough. Toby Edelman, a senior policy attorney […]

Lawsuit Over Three-Day Stay Rule for Medicare SNF Coverage Begins as Verma Promises: ‘We’re Listening’

A class-action lawsuit challenging the Medicare eligibility rules for skilled nursing coverage will finally get its day in court this week — shortly after the administrator in charge of the program publicly questioned the status quo. The trial over the lawsuit, first filed in 2011, began Monday in a Hartford federal courtroom, according to an […]

Genesis Targets Increased Real Estate Ownership as CEO Touts Strength of its ACO

Genesis HealthCare (NYSE: GEN) reported improvement in its 2019 second-quarter financial results, and CEO George Hager is optimistic about the second half of the year — in part because of the skilled nursing operator’s participation in the Medicare Shared Savings Program (MSSP) as an accountable care organization (ACO). The skilled nursing giant, which operates about […]

Omega Offers Details on $735M Skilled Nursing Pickup, Ongoing Daybreak Woes

Omega Healthcare Investors (NYSE: OHI) made a major splash this week with the announcement of a planned $735 million skilled nursing acquisition, though executives also reported that a troubled tenant in Texas hasn’t generated any revenue for the real estate investment trust (REIT) yet this quarter. Daybreak Venture met its rent obligations under a deferral […]

Omega to Buy 58 Skilled Nursing Facilities in $735 Million Deal

Omega Healthcare Investors (NYSE: OHI) on Tuesday announced plans to pick up 58 skilled nursing facilities in a 60-building deal valued at $735 million. The Hunt Valley, Md.-based real estate investment trust (REIT) agreed to the deal on July 26, Omega reported this week, though it remains subject to approval by the Department of Housing […]

Under PDPM, Benefits of In-House Medicare Advantage Plans Will Go Beyond Money

Forward-thinking skilled nursing providers have increasingly warmed to the idea of starting a special kind of in-house Medicare Advantage plan in order to take more control over their reimbursements in an uncertain environment. But the strategies that operators must adopt to succeed with Institutional Special Needs Plans (I-SNPs) also fit seamlessly into preparations for the […]

Genesis Exec: ACOs May Work Better Than I-SNPs for Skilled Nursing Facilities

Skilled nursing providers, seeking more control over their own destiny and the premium dollar, have been driving the growth of a specific subtype of Medicare Advantage plan designed for the care of patients in the institutional setting. But Jason Feuerman, senior vice president for strategic development and managed care at nationwide operator Genesis HealthCare (NYSE: […]

CMS Finalizes $851M Pay Bump for Nursing Homes, Rolls Out PDPM Clarifications

The federal government on Tuesday finalized a predicted funding increase for nursing homes, while also formalizing changes to several key quality programs — with an eye toward clarifying some parts of the new Medicare payment model for skilled nursing facilities. Under the terms of the 2020 final rule for Medicare skilled nursing facilities, the Centers […]

OIG: ACOs Use Three-Day Stay Waiver, Preferred Providers to Manage SNF Costs

Preferred provider networks of skilled nursing facilities, embedding staff onsite and conducting so-called “warm handoffs” were among the strategies that top accountable care organizations (ACOs) use to manage costs in the SNF and home health care setting. Because Medicare spending is expected to surpass $1.5 trillion by 2028, more than double the spending of $708 […]

Respiratory Therapy’s ‘Massive’ Skilled Nursing Opportunity Under PDPM

As providers continue to stare down the October 1 implementation of a new Medicare payment model for nursing homes, specialization remains at the top of many operators’ to-do lists — with respiratory therapy potentially emerging as a key revenue source. Because the Patient-Driven Payment Model (PDPM) matches reimbursements with resident acuity, operators have looked to […]

Research, Ability and Track Record: How SNFs Have to Help Referrers Under PDPM

With the Medicare reimbursement overhaul taking place in a few short months, skilled nursing facilities — ideally — are moving into the last stages of preparation and training for staff and workflow procedures. But according to post-acute care partnership strategist Mike Wetula of therapy company TMC, SNFs can’t ignore their referral partners in the process. […]

Cost-Cutting Consequences: Improper Discharges Home, Financial Strain for SNFs

In a rush to find savings amid a changing payment landscape, hospitals have turned to the reduction in institutional post-acute care, especially in skilled nursing facilities. But that determination to secure savings could have unintended consequences for patients, their families, and SNFs, according to a perspective article published Wednesday in the New England Journal of […]

Growing Physician Group Plots SNF Psychiatric Push — Both in Person and Remotely

As resident acuities rise and reimbursements more closely link up with resident results, boosting physician services in skilled nursing facilities has emerged as a potential strategy to improve both outcomes and income — whether it’s through in-person visits or telehealth. In the northwest corner of Washington state, Swenson Healthcare has been taking something of a […]

Number of I-SNP Plans Goes Up Almost 30% Year-Over-Year

The number of skilled nursing providers interested in becoming insurers has grown for the past several months. Now hard numbers show just how great that interest is. Special needs plans are a category within Medicare Advantage (MA) that provide a common framework for the plans that serve special-needs beneficiaries, while also expanding beneficiary choice and […]

PDPM Countdown: ‘We Are All Crossing Our Fingers and Knocking on Wood’

With the Medicare Part A reimbursement overhaul taking effect in just a few months, skilled nursing providers across the country are in countdown mode. But the clock is moving at different paces for different providers, several experts said. Some SNFs began their analysis and preparations months ago; others are barely getting started. That’s led to […]

Legislators React to SNF Arbitration Ban Reversal: ‘New Rule Does Not Put Patients First’

The Centers for Medicare & Medicaid Services overturned a ban on skilled nursing operators using pre-dispute arbitration agreements with their residents in a final rule issued July 16, and a range of lawmakers reacted throughout the week. The ban on arbitration agreements in long-term care was implemented by the Obama administration in 2016, to strong […]

CMS Releases New Skilled Nursing Affiliate Data for ACOs as More Take on Risk

The Centers for Medicare & Medicaid Services’ (CMS) overhaul of the Medicare Shared Savings Program is paying off in the form of greater accountability and more risk-taking, CMS administrator Seema Verma wrote in a blog post published Wednesday in Health Affairs. The post came as part of an announcement about accountable care organization (ACO) participation […]

CMS’s Regulatory Delay: What’s In, What’s Out, and Why Nursing Homes Could ‘Substantially’ Reduce Costs

Skilled nursing facilities could see relief from regulatory burdens if a proposed rule from the Centers for Medicare & Medicaid Services (CMS) takes effect, and according to the agency, it could lead to millions in savings. Specifically, the rule would overhaul multiple requirements and delay the implementation of regulations related to the Quality Assurance and […]